br Funding Source br Acknowledgements Data collection

Funding Source
Acknowledgements Data collection was supported by the Swedish Council for Working Life and Social Research, the Stockholm University Linnaeus Center for Integration Studies, and by a European Research Council Starting Grant [grant no. 263422] awarded to Jens Rydgren.
Introduction Chinese economic reform, launched in the late 1970s, brought massive macroeconomic and institutional transformations. Accordingly, a great deal of scholarly attention has been devoted to the consequences of large-scale societal transformations for Chinese lives. Earlier studies have focused on social stratification and social mobility, spawning a large body of market transition literature (Hannum & Xie, 1994; Nee, 1991). Recently, increasing attention has been given to the quality of life, such as physical health and psychological well-being (e.g., Brockmann, Delhey, Welzel, & Yuan, 2009; Chen, Yang, & Liu, 2010; Easterlin, Morgan, Switek, & Wang, 2012; Schafer & Kwon, 2012; Steele & Lynch, 2013; Tang, 2014; Whyte & Sun, 2010). In this paper, we examine health implications of China’s social changes from 1990 to 2012. How has self-rated health changed during economic reform? How have socioeconomic inequalities in health changed during this period?
Methods
Results We first use descriptive statistics to examine unadjusted percentages of “good”/“very good” self-rated health (hereafter, good SRH) across time points. As displayed in Fig. 1, the percentage of Chinese adults with good SRH increased from 55% in 1990 to 68% in 1995. This percentage decreased to 61% in 2001, remains nearly unchanged by 2007, and then again increases to 67% in 2012. The percentage in all four time points, with the exception of 2001, is significantly higher than 1990. Table 2 presents the odds ratios of reporting good SRH obtained from CCREMs. The variance components, showing how much of the variability in good SRH occurs at the cohort and erbb2 inhibitor levels, are reported in the bottom of Table 2. Our analyses begin with a model (Model1) where age, age-squared, period and cohorts are included without other covariates. Model 2 through Model 5 adds individual-level covariates. Income and education are included separately in the consideration of their positive correlation (r=0.17) and because income has been considered a mediating link between education and health (Beckfield, Olafsdottir, & Bakhtiari, 2013; Starfield, 2006). Finally, both factors are included simultaneously (Model 6 and Model 7). Model 1 shows significant age, period and cohort effects. Fig. 2a shows that the probability of good SRH decreases with age. Fig. 2b displays a general upward trend across time, though the increase is not monotonic. The probability of good SRH underwent a remarkable upward trend from 0.56 in 1990 to 0.69 in 1995, declined in 2001, then rebounded in 2012. Overall, the likelihood of good SRH increased over the past two decades. This contrasts with temporal trends in the U.S where SRH has been quite stable over the last three decades (Beck, Finch, & Lin, 2014), perhaps pointing to the impact of socioeconomic change in reform-era China. Cohort differentials, net of age and period effects, are displayed in Fig. 2c, exhibiting a distinct upward and almost monotonic pattern where the predicted probability of good SRH has increased across subsequent birth cohorts. Although there is a significant cohort effect (τν=0.011; p< 0.05), period effects principally contribute to the upward trends in SRH during the reform era (=0.051; p<0.001). Age and period effect remains significant in Model 2 net of income and all other covariates. Cohort effects, however, become non-significant. Higher income is positively related to good SRH. Random effects of income reported in the bottom of Model 3, estimated with a cross-level interaction at level 1 (e.g., income) and level 2 (e.g., period) shows a significant temporal change in income-based differentials in health. Note that the random effects estimate for middle quartile income was approximately zero, so it was not reported. Fig. 3a estimated from model 3 shows that income gaps in SRH have persisted across the entire period of observations, and have increased over time. The increasing income gap results from those in high income improving SRH, while those with low incomes have remained flat.